Browse > Article
http://dx.doi.org/10.3340/jkns.2013.54.3.201

Sagittal Sacropelvic Morphology and Balance in Patients with Sacroiliac Joint Pain Following Lumbar Fusion Surgery  

Cho, Dong-Young (Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea)
Shin, Myung-Hoon (Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea)
Hur, Jung-Woo (Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea)
Ryu, Kyeong-Sik (Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea)
Park, Chun-Kun (Department of Neurosurgery, Spine and Joint Research Institute, Gangdong Teun Teun Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.54, no.3, 2013 , pp. 201-206 More about this Journal
Abstract
Objective : To investigate the sagittal sacropelvic morphology and balance of the patients with SIJ pain following lumbar fusion. Methods : Among 452 patients who underwent posterior lumbar interbody fusion between June 2009 and January 2013, patients with postoperative SIJ pain, being responded to SIJ block were enrolled. For a control group, patients matched for sex, age group, the number of fused level and fusion to sacrum were randomly selected. Patients were assessed radiologic parameters including lumbar lordosis, pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS). To evaluate the sagittal sacropelvic morphology and balance, the ratio of PT/PI, SS/PI and PT/SS were analyzed. Results : A total of 28 patients with SIJ pain and 56 patients without SIJ pain were assessed. Postoperatively, SIJ pain group showed significantly greater PT (p=0.02) than non-SIJ pain group. Postoperatively, PT/PI and SS/PI in SIJ pain group was significantly greater and smaller than those in non-SIJ pain group respectively (p=0.03, 0.02, respectively) except for PT/SS (p=0.05). SIJ pain group did not show significant postoperative changes of PT/PI and SS/PI (p=0.09 and 0.08, respectively) while non-SIJ pain group showed significantly decrease of PT/PI (p=0.00) and increase of SS/PI (p=0.00). Conclusion : This study presents different sagittal sacropelvic morphology and balance between the patients with/without SIJ pain following lumbar fusion surgery. The patients with SIJ pain showed retroversed pelvis and vertical sacrum while the patients without SIJ pain have similar morphologic features with asymptomatic populations in the literature.
Keywords
Sacroiliac joint pain; Lumbar fusion surgery; Sacropelvic morphology; Lumbopelvic parameters;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Kim Y, Bridwell K, Lenke L, Rhim S, Cheh G : An analysis of sagittal spinal alignment following long adult lumbar instrumentation and fusion to L5 or S1 : can we predict ideal lumbar lordosis? Spine (Phila Pa 1976) 31 : 2343-2352, 2006   DOI
2 Lafage V, Schwab F, Patel A, Hawkinson N, Farcy J : Pelvic tilt and truncal inclination : two key radiographic parameters in the setting of adults with spinal deformity. Spine (Phila Pa 1976) 34 : E599-E606, 2009   DOI
3 Liliang P, Lu K, Liang C, Tsai Y, Wang K, Chen H : Sacroiliac joint pain after lumbar and lumbosacral fusion : findings using dual sacroiliac joint blocks. Pain Med 12 : 565-570, 2011   DOI
4 Le Huec JC, Aunoble S, Philippe L, Nicolas P : Pelvic parameters : origin and significance. Eur Spine J 20 Suppl 5 : 564-571, 2011   DOI
5 Lee C, Chung S, Kang K, Park S, Shin S : Normal patterns of sagittal alignment of the spine in young adults radiological analysis in a Korean population. Spine (Phila Pa 1976) 36 : E1648-E1654, 2011   DOI
6 Legaye J, Duval-Beaupre G, Hecquet J, Marty C : Pelvic incidence : a fundamental pelvic parameter for three-dimensional regulation of spinal sagittal curves. Eur Spine J : 99-103, 1998
7 Ahn Y, Lee S : Iatrogenic sacroiliac joint syndrome after percutaneous pedicle screw fixation at the L5-S1 level : case report. Neurosurgery 67 : E865-E866, 2010   DOI
8 Ames CP, Smith JS, Scheer JK, Bess S, Bederman SS, Deviren V, et al. : Impact of spinopelvic alignment on decision making in deformity surgery in adults. J Neurosurg Spine 16 : 547-564, 2012   DOI
9 Barrey C, Jund J, Perrin G, Roussouly P : Spinopelvic alignment of patients with degenerative spondylolisthesis. Neurosurgery 61 : 981-986, 2007   DOI
10 Berthonnaud E, Dimnet J, Roussouly P, Labelle H : Analysis of the sagittal balance of the spine and pelvis using shape and orientation parameters. J Spinal Disord 18 : 40-47, 2005   DOI
11 Roussouly P, Gollogly S, Berthonnaud E, Dimnet J : Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine (Phila Pa 1976) 30 : 346-353, 2005   DOI
12 Schwab F, Lafage V, Patel A, Farcy J : Sagittal plane considerations and the pelvis in the adult patient. Spine (Phila Pa 1976) 34 : 1828-1833, 2009   DOI
13 Schwarzer AC, Aprill CN, Bogduk N : The sacroiliac joint in chronic low back pain. Spine (Phila Pa 1976) 20 : 31-37, 1995   DOI
14 Vialle R, Ilharreborde B, Dauzac C, Lenoir T, Rillardon L, Guigui P : Is there a sagittal imbalance of the spine in isthmic spondylolisthesis? A correlation study. Eur Spine J 16 : 1641-1649, 2007   DOI
15 Duval-BeaupÃfre G, Robain G : Visualization on full spine radiographs of the anatomical connections of the centres of the segmental body mass supported by each vertebra and measured in vivo. Int Orthop 11 : 261-269, 1987   DOI
16 Duval-Beaupére G, Schmidt C, Cosson P : A Barycentremetric study of the sagittal shape of spine and pelvis : the conditions required for an economic standing position. Ann Biomed Eng 20 : 451-462, 1992   DOI
17 Ebraheim NA, Elgafy H, Semaan HB : Computed tomographic findings in patients with persistent sacroiliac pain after posterior iliac graft harvesting. Spine 25 : 2047-2051, 2000   DOI
18 Gottfried O, Daubs M, Patel A, Dailey A, Brodke D : Spinopelvic parameters in postfusion flatback deformity patients. Spine J 9 : 639-647, 2009   DOI
19 Fritzell P, Hägg O, Wessberg P, Nordwall A : 2001 Volvo Award Winner in Clinical Studies : Lumbar fusion versus nonsurgical treatment for chronic low back pain : a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 26 : 2521-2532, 2001   DOI
20 Frymoyer JW, Howe J, Kuhlmann D : The long-term effects of spinal fusion on the sacroiliac joints and ilium. Clin Orthop Relat Res : 196-201, 1978
21 Gangnet N, Dumas R, Pomero V, Mitulescu A, Skalli W, Vital JM : Three-dimensional spinal and pelvic alignment in an asymptomatic population. Spine (Phila Pa 1976) 31 : E507-E512, 2006   DOI
22 Huec JC, Charosky S, Barrey C, Rigal J, Aunoble S : Sagittal imbalance cascade for simple degenerative spine and consequences : algorithm of decision for appropriate treatment. Eur Spine J 20 : 699-703, 2011   DOI
23 Katz V, Schofferman J, Reynolds J : The sacroiliac joint : a potential cause of pain after lumbar fusion to the sacrum. J Spinal Disord 16 : 96-99, 2003   DOI
24 Debarge R, Demey G, Roussouly P : Radiological analysis of ankylosing spondylitis patients with severe kyphosis before and after pedicle subtraction osteotomy. Eur Spine J 19 : 65-70, 2010   DOI
25 Bose B : Outcomes after posterolateral lumbar fusion with instrumentation in patients treated with adjunctive pulsed electromagnetic field stimulation. Adv Ther 18 : 12-20, 2001   DOI
26 Mac Thiong J, Wang Z, de Guise JA, Labelle H : Postural model of sagittal spino-pelvic alignment and its relevance for lumbosacral developmental spondylolisthesis. Spine (Phila Pa 1976) 33 : 2316-2325, 2008   DOI
27 Breslow NE, Day NE : Statistical methods in cancer research. Volume I - The analysis of case-control studies. Lyons, France : IARC Sci Publ, 1980, Vol 1, pp5-338
28 Mac-Thiong JM, Roussouly P, Berthonnaud E, Guigui P : Age- and sex-related variations in sagittal sacropelvic morphology and balance in asymptomatic adults. Eur Spine J 20 Suppl 5 : 572-577, 2011
29 Mac Thiong J-M, Labelle H, Charlebois M, Huot M-P, de Guise J : Sagittal plane analysis of the spine and pelvis in adolescent idiopathic scoliosis according to the coronal curve type. Spine (Phila Pa 1976) 28 : 1404-1409, 2003
30 Maigne JY, Aivaliklis A, Pfefer F : Results of sacroiliac joint double block and value of sacroiliac pain provocation tests in 54 patients with low back pain. Spine (Phila Pa 1976) 21 : 1889-1892, 1996   DOI
31 Maigne JY, Planchon CA : Sacroiliac joint pain after lumbar fusion. A study with anesthetic blocks. Eur Spine J 14 : 654-658, 2005   DOI
32 Morel E, Ilharreborde B, Lenoir T, Hoffmann E, Vialle R, Rillardon L, et al. : [Sagittal balance of the spine and degenerative spondylolisthesis]. Revue de Chirurgie Orthopédique et Réparatrice de l Appareil Moteur 91 : 615-626, 2005   DOI
33 Shin MH, Ryu KS, Hur JW, Kim JS, Park CK : Comparative Study of Lumbopelvic Sagittal Alignment Between Patients With and Without Sacroiliac Joint Pain After Lumbar Interbody Fusion. Spine (Phila Pa 1976), 2013